Spine
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Randomized Controlled Trial
The Influence of Simulated Low Speed Vehicle Impacts and Posture on Passive Intervertebral Mechanics.
An in vitro biomechanics investigation exposing porcine functional spinal units (FSUs) to sudden impact loading although in a flexed, neutral, or extended posture. ⋯ Functional spinal units exposed to the highest severity impact (11 g) had significant neutral zone changes, with increases in joint laxity in flexion-extension and anterior-posterior shear and decreased stiffness, suggesting that soft tissue injury may have occurred. Despite observed main effects of impact severity, no influence of posture was observed.Level of Evidence: N/A.
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Fourteen cadaveric specimens were separated into two groups: (1) L3 pedicle subtraction osteotomy (PSO) with transforaminal lumbar interbody fusion (TLIF) or (2) lateral lumbar interbody fusion (LLIF). A 2-rod configuration (2R) was compared with two supplemental rod configurations: 4-rod (4R) with accessory rods (ARs) using connectors or 4R with satellite rods (SRs) without connectors. ⋯ Both supplemental rod configurations reduced motion in both groups. Constructs with the SR configuration increased the primary rod strain and the sacral screw bending moment compared with AR constructs, which can share strain. Deep-seated SRs, which have become increasingly popular, may be more vulnerable to failure than ARs. LLIF provided more stability in sagittal plane. Protective effect of supplemental rods on rod strain was more effective with TLIF.Level of Evidence: NA.
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Observational Study
Persistent Use of Prescription Opioids Following Lumbar Spine Surgery: Observational Study with Prospectively Collected Data from Two Norwegian Nationwide Registries.
Prospective pharmacoepidemiological study. ⋯ Patients with or at risk of developing persistent opioid should be identified and provided counseling and support to taper off opioid treatment.Level of Evidence: 2.
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A retrospective study. ⋯ Skeletally immature patients with long thoracic curve, preoperative coronal imbalance, large rotation, and deviation of LSTV-1 are at increased risk of distal adding-on when selecting LSTV-1 as LIV. Under this condition, distal fusion level should extend to LSTV; while in other case, LSTV-1 could be a valid LIV.Level of Evidence: 4.
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Quasi-experimental intervention study. ⋯ After implementation of the care bundle, the incidence of SSI in spine fusion surgery decreased significantly. Multivariate analysis showed that the care bundle was an independent protective factor. The implementation of these measures should be reinforced on the routine medical practice to reduce the SSI incidence.Level of Evidence: 3.